Study On Efficacy And Mechanism Of Xinning Tablet Against Myocardial Ischemia From Inflammatory Pathway

Objective:To evaluate clinical effect of Xinning tablets on Angina and explore its anti-myocardial ischemia mechanism from the inflammatory signaling pathway.Method:1.According evidence-based medicine and DME,the clinical and ECG,nitroglycerin consumption effects of Xinning tablets on patients with stable angina was observed,and inflammatory cytokines TNF,IL-1 in patients serum was checked,and compared with diltiazem.2.Using coronary artery ligation induced myocardial ischemia model, animals were randomized,administrated respectively and killed at 12,24 hour after operation,level and expression of TNF-α,IL-1,VCAM-1,NO, NFkB family proteins were cheched using ELISA and immunohistochemistry and PCR method.Results:1.Total efficiency,incidence of total efficiency and syndromes of the total efficiency on angina of Xinning tablet was 87.8%,72.7%and 90.9%,that was significantly better than that of the control group(75.0%, 65.6%and 81.3%)(p＜0.05),but also Xinning tablet can significantly improve chest tightness,chest pain symptoms and serum levels of TNF-αand IL-1(p＜0.05).2.There was a certain amount of expression of VCAM-1 and TNF-αin the normal heart,after myocardial ischemia both were increased significantly, diltiazem and Xinning can reduced expression of VCAM-1 and TNF-α, compared with the model group,The difference was significant(P＜0.05),the difference of TNF-αbetween Xinning group and diltiazem was also significant,P＜0.05,but in VCAM-1 there was not significant difference p＞0.05.3.There was certain level of IL-1,iNOS in normal rat serum,both were rapid increase after myocardial ischemia,Xinning and diltiazem can reduce level of IL-1,iNOS,compared with model group the difference was significant,and differences between Xinning and diltiazem was significant,P＜0.05.4.Under normal circumstances NFkBP65 and IkB had lower levels of expression,after Myocardial ischemia expression of NFkBP65 was increased but that of IkB was inhibited,Diltiazem and Xinning tablets can reduce NFkBP65 expression and increase IkB expression,compared with model group,the difference was significant,P＜0.05;and there was significant between diltiazem and Xinning tablets,P＜0.05.Conclusions:1.Xinning tablet can significantly improve clinicl efficacy the electrocardiogram,myocardial ischemia and symptoms of angina pectoris, and regulate serum cytokine levels,that shows it is an ideal anti - angina drugs.2.Xinning tablet can significantly improve cytokines in myocardial ischemia rat,reduce vascular adhesion molecule-1 and NO kinase,regulate of NF-kB activation and the expression of IjB,That is one possible mechanism against ischemia affected inflammatory signaling pathways.